The Health Care Group’s newest partners, William S.W. Chang and Laura M. Kidd Cordova, along with Counsel Stephanie D. Willis, have authored an Alert about the 21st Health Care Fraud and Abuse Control Program (HCFAC) annual report released last Friday. The HCFAC report is a joint effort of the U.S. Department of Justice (DOJ) and
Health Care Fraud and Abuse Control Program
FY 2014 HCFAC Report Shows Increasing DOJ and OIG Fraud-Fighting Efficiency
Every year, the Department of Justice (DOJ) and the Department of Health and Human Services Office of the Inspector General (OIG) report the results of their fraud prevention and recovery efforts to Congress. As recounted in the recently released Health Care Fraud and Abuse Control Program (HCFAC) report, the overall amount recovered in FY 2014 was $1 billion less than what the agencies reported in 2013 ($4.3 billion). Nevertheless, the report touted the $2 increase in the return on investment from DOJ and OIG’s fraud and abuse investigations overall (from $5.70 to $7.70). The HCFAC report shows that, despite losing $62.1 million in funding beginning in FY 2013 due to sequestration, both DOJ’s and OIG’s antifraud work remains potent and is growing more sophisticated.
Here is an overall comparison of the FY 2014 and FY 2013 reports:
DOJ Activities | FY 2013 | FY 2014 |
New Criminal Investigations | 1,013 | 924 |
New Civil Investigations | 1,083 | 782 |
Health Care Fraud Convictions | 718 | 734 |
Total Allocation | $573,667,581 | $571,702,217 |
OIG Activities | FY 2013 | FY 2014 |
New Criminal Actions | 849 | 924 |
New Civil Actions | 458 | 529 |
Individuals Excluded from Federal Health Care Programs | 3,214 | 4,017 |
Total Allocation | $487,381,848 | $485,824,633 |
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